I’m in a bit of a situation. This year I’ve had recurring depression that’s been quite nasty. My doctor has said for a while that my bipolar needs long term anti-depressant treatment, as the mood stabilisers alone don’t seem to have enough anti-depressant effect.

So far we have trialed a number of anti-depressants. It seems that the SNRI’s, despite lifting me out of depression, have a negative effect on my addiction (ie they’re known to induce periods of heavy drug use), so these are not an option.

I’m interested in knowing other people’s experiences with anti-depressants while on Sub. Recently I had a positive experience with Agomelatine, which isn’t released in the US. However the last couple of weeks it seems to have lost all effect, and raising the dose had little impact. With the return of depression I also had a period of drug use. It seems that these days the only time I even want to use drugs is when I fall back into depression.

What anti-depressants have people found to be effective while on Suboxone? I’m particularly interested in which ones people have found may have interacted with Sub, or sped up or slowed down their metabolism of Sub. My doctor thinks the next one we try should be Mirtazapine (Remeron or Avanza), as it is not an SSRI/SNRI and seems to be quite effective. Is anyone else on this medication?

There’s also Moclebemide, a reversible MAOI, which was suggested by an addiction specialist.

What about the TCA’s? Anyone have experience with them?

Thanks…

tj